Cancer Treatment (Medical Oncology)

Cancer Treatment

Breast Cancer

What it is:

Breast cancer starts in the ducts (tubes that carry milk) or lobules (milk-producing glands) of the breast. It is the most common cancer in women but is highly treatable if caught early.

Symptoms:

• A lump in the breast or underarm
• Change in breast size or shape
• Nipple discharge, especially blood
• Skin changes like dimpling or redness
• Persistent pain in the breast

Diagnosis:

• Mammogram: A special breast X-ray that can detect lumps before they are felt.
• Ultrasound: Uses sound waves to check if a lump is solid or fluid filled.
• Biopsy: Removing a small piece of breast tissue to check under the microscope.
• Molecular Testing: Tests to check hormone receptors (ER/PR) and HER2 status — this helps decide treatment.
• PET-CT scan (Positron Emission Tomography – Computed Tomography): Combines imaging and functional tests to check if cancer has spread.

Treatment:

• Surgery: Removal of the lump (lumpectomy) or the entire breast (mastectomy).
• Chemotherapy: Strong medicines given by drip or tablets to kill cancer cells.
• Targeted Therapy: Medicines like trastuzumab that attack specific cancer cell markers (HER2-positive cancers).
• Hormone Therapy: Used if the cancer is sensitive to oestrogen or progesterone hormones.
• Radiation Therapy: High-energy rays to destroy cancer cells after surgery.
• Immunotherapy: Medicines that help the immune system recognize and fight cancer (for specific cases).

Lung Cancer

What it is:

Lung cancer begins in the lungs, usually in people who smoke, but non-smokers can get it too. There are two main types — non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

Symptoms:

• Long-lasting cough that doesn’t go away
• Coughing up blood
• Chest pain, especially when breathing deeply
• Shortness of breath
• Hoarseness or voice change
• Weight loss and tiredness

Diagnosis:

• CT scan (Computed Tomography): Detailed imaging to look for tumours.
• Biopsy: Sample taken through bronchoscopy (camera passed into lungs) or a needle guided by CT.
• Molecular Testing: Looks for mutations (EGFR, ALK, ROS1, KRAS) — these decide if tablets (targeted drugs) can be used instead of chemotherapy.
• PET-CT and Brain MRI: To check if cancer has spread.

Treatment:

• Surgery: Best if the cancer is caught early and confined to one part of the lung.
• Radiation Therapy: Used when surgery is not possible.
• Chemotherapy: Given in cycles to shrink or control the disease.
• Targeted Therapy: Tablets designed to block cancer-driving mutations (for example, EGFR inhibitors).
• Immunotherapy: Boosts the body’s own immune system to fight cancer.

Colorectal Cancer

What it is:

Cancer that starts in the colon (large intestine) or rectum. It usually begins as small growths called polyps, which can turn cancerous over time.

Symptoms:

• Blood in stool (red or black)
• Change in bowel habits (diarrhea, constipation, narrow stools)
• Abdominal cramps or pain
• Unexplained weight loss
• Feeling tired due to anaemia (low red blood cells)

Diagnosis:

• Colonoscopy: A thin tube with a camera is passed through the rectum to check the colon and take a biopsy.
• Biopsy: Tissue checks to confirm cancer.
• CEA (Carcinoembryonic Antigen) Test: A blood marker sometimes raised in colorectal cancer.
• CT/MRI Scan: To see the extent of spread.
• Genetic Testing (MSI-H/dMMR): Checks if the cancer has special features that respond to immunotherapy.

Treatment:

• Surgery: Removal of the affected part of the intestine.
• Chemotherapy: Medicines like FOLFOX (5-FU, Oxaliplatin, Leucovorin) to kill cancer cells.
• Targeted Therapy: Drugs that block blood supply to tumors (bevacizumab) or cell growth signals.
• Immunotherapy: For cancers with MSI-H/dMMR results.

Gynaecological Cancers (Cervical, Ovarian, Endometrial)

What they are:

• Cervical Cancer: Starts in the cervix (the lower part of the uterus).
• Ovarian Cancer: Starts in the ovaries, often detected late.
• Endometrial Cancer: Starts in the lining of the uterus.

Symptoms:

• Abnormal bleeding (between periods, after menopause, after intercourse)
• Pelvic pain or bloating
• Increased urination or constipation
• Unexplained weight changes

Diagnosis:

• Pap Smear and HPV Test: Detects precancerous changes in the cervix.
• Ultrasound & MRI: Imaging of the uterus, ovaries, and pelvis.
• CA-125 Blood Test: A marker often raised in ovarian cancer.
• Biopsy: Sample of tissue from cervix, endometrium, or ovary.

Treatment:

• Surgery: Removal of tumour and sometimes uterus/ovaries.
• Chemotherapy: Standard for ovarian cancers.
• Radiation Therapy: Used mainly in cervical and endometrial cancers.
• Targeted Therapy: PARP inhibitors in ovarian cancers with BRCA gene changes.
• Immunotherapy: For advanced cases with specific genetic changes.